Fractional diastolic and systolic pressure in the ascending aorta are related to the extent of coronary artery disease

Jankowski, Piotr; Kawecka‐Jaszcz, Kalina; Bryniarski, Leszek; Czarnecka, Danuta; Brzozowska-Kiszka, M; Pośnik-Urbańska, Aneta; Kopeć, Grzegorz; Dragan, Jacek; Klecha, Artur; Dudek, Dariusz

doi:10.1016/j.amjhyper.2004.01.009

Cited by 41 publications

(29 citation statements)

References 18 publications

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“…The major hemodynamic finding of our study was that in patients with CAS, PP was markedly increased not only in the ascending aorta 16 but also in the abdominal aorta at the level of renal arteries. PP amplification was mainly due to a slight increase in SBP along the aorta, in association with a consistently lowered DBP, which was around a value of 70 mm Hg.…”

Section: Aortic Pp Amplificationmentioning

confidence: 63%

Intraaortic Pulse Pressure Amplification in Subjects at High Coronary Risk

et al. 2010

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Abstract-Peripheral (brachial) pulse pressure normally exceeds central (aortic) pulse pressure but is a less powerful predictor of cardiovascular risk. The difference between the 2 variables, called pulse pressure amplification, has never been specifically studied between the proximal and distal aorta in coronary patients. Our goal was to determine aortic pulse pressure amplification in subjects at high coronary risk, with emphasis on associated renal and inflammatory factors. Blood pressure was measured invasively in the ascending aorta, abdominal aorta (at the level of kidneys), and iliac artery in 101 subjects (mean age, 63Ϯ11 years; 61 men) undergoing coronary angiography. Independently of age, sex, and the presence of coronary stenosis, the increase of pulse pressure between the ascending and terminal aorta was over 10 mm Hg (PϽ0.001), whereas mean blood pressure remained unchanged. Pulse pressure amplification did not differ significantly between patients with and without coronary artery stenosis. Irrespective of confounding variables, high pulse pressure measured in the ascending aorta and at the level of renal arteries (but not in the iliac artery) was independently related to proteinuria. The increase in pulse pressure from the ascending aorta to the renal level was negatively associated with leukocyte count, even after multivariate adjustment (␤ coefficient, Ϫ0. Key Words: central pulse pressure Ⅲ pulse pressure amplification Ⅲ coronary artery disease Ⅲ chronic kidney disease Ⅲ blood pressure P eripheral (brachial) pulse pressure (PP) constantly exceeds central (aortic) PP but is a less powerful predictor of cardiovascular (CV) risk. 1,2 Several factors are involved in the development of this difference. 1,3 Among them, 3 factors can be considered to have major importance for the higher predictive value of central PP compared with brachial PP: the presence of aortic PP amplification, anomalies of kidney structure and function, and inflammatory factors. 4 It has been shown that systolic blood pressure (SBP) and PP are physiologically higher in peripheral than in central arteries. 1,4 -6 In contrast, peripheral diastolic blood pressure (DBP) is slightly lower compared with central DBP. 1,4 -6 Finally, nearly identical values are observed regarding mean blood pressure (MBP). This well-established behavior of the different blood pressure (BP) components is known to protect the heart against an increase in afterload, but it tends to lessen with age. 5,7 Increased arterial stiffness and alterations in the transit of wave reflections are major determinants of SBP and PP amplification. 3 Pressure amplification between the carotid and brachial arteries has been widely studied in the literature, but amplification between the proximal and distal aorta has never been investigated in subjects with coronary atherosclerosis. 1,5 Just in the middle of the abdominal aorta is the kidney, an important organ to consider. In subjects with hypertension or chronic renal disease, increased aortic stiffness or indices of pul...

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Section: Aortic Pp Amplificationmentioning

confidence: 63%

Intraaortic Pulse Pressure Amplification in Subjects at High Coronary Risk

et al. 2010

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“…Most studies [33][34][35] other than one [36] found centrally measured aortic pulse pressure or carotid pressure rather than brachial pulse pressure to correlate with CAD. The present study takes this analysis a stage further relating brachial pulse pressure to total but primarily non-obstructive, atheroma, determined non-invasively in asymptomatic patients with diabetes mellitus, while in keeping with most previous studies finding no correlation between brachial pulse pressure and obstructive coronary disease.…”

Section: Pulse Pressure As a Predictor Of Coronary Arterial Atheromamentioning

confidence: 96%

Pulse pressure and coronary atherosclerosis in asymptomatic type 2 diabetes mellitus: A 64 channel cardiac computed tomography analysis

Halon¹,

Dobrecky‐Mery²,

Gaspar³

et al. 2010

International Journal of Cardiology

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“…The use of a high-fidelity pressure transducer could increase the accuracy of the recorded pressure waveform. However, the fluid-filled system has been used commonly in clinical studies (16,41,42). In clinical practice, access to a high-fidelity pressure transducer is limited, and use of such a system requires additional procedures that prolong the already invasive measurement.…”

Section: Discussionmentioning

confidence: 99%

Aortic Pulse Wave Velocity and Carotid-Femoral Pulse Wave Velocity: Similarities and Discrepancies

et al. 2007

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Fractional diastolic and systolic pressure in the ascending aorta are related to the extent of coronary artery disease

Abstract: Pulse pressure (PP), FSP, and FDP of the ascending aorta are related to the risk of three-vessel disease in patients with coronary artery disease and preserved left ventricular function.

Cited by 41 publications

References 18 publications

Intraaortic Pulse Pressure Amplification in Subjects at High Coronary Risk

Intraaortic Pulse Pressure Amplification in Subjects at High Coronary Risk

Pulse pressure and coronary atherosclerosis in asymptomatic type 2 diabetes mellitus: A 64 channel cardiac computed tomography analysis

Aortic Pulse Wave Velocity and Carotid-Femoral Pulse Wave Velocity: Similarities and Discrepancies

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